MEDICARE: MISS CHRISTINE RENEE LOWE CT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1528735362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHRISTINE RENEE LOWE CT

Provider Business Mailing Address
First Line	:	35104 EUCLID AVE SUITE 305
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094
Country	:	US
Telephone Number	:	440-527-8006
Fax Number	:

Provider Business Practice Location Address
First Line	:	35104 EUCLID AVE STE 305
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-4566
Country	:	US
Telephone Number	:	440-527-8006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2021
Last Update Date	:	08/28/2021

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